[The disorder of cerebral circulation in patients of able-bodied age].

The study was organized to evaluate influence of risk factors on hospital mortality in patients with acute stroke because incidence of stroke in patients of able-bodied age is increasing. All cases of in-patient care of patients of able-bodied age with acute stroke (n=4118) in the Tyumen Oblast clinical hospital № 2 during 2010-2018 were analyzed. The study was based on sampling data from hospital medical records. During the analyzed period, decreasing of in-patient lethality up to 34.9% in patients of able-bodied age was observed. During the period of "therapeutic window" 60% of patients of able-bodied age admitted died. The multivariate analysis was applied to assess influence of different factors on in-patient mortality. The presence of coronary heart disease increases risk of mortality up to 47.5%, Exp(Beta)=1.475, employment - up to 66.8%, Exp(Beta)=1.668 as compared to baseline risk. The presence of arterial hypertension and remoteness of symptom onset in ln (hours) (hospital admission) decreases mortality risk up to approximately 39.7%, Exp (Beta)=0.603 and up to 24.0%, Exp (Beta)=0.760, respectively (specificity - 75.86%, sensitivity - 72.18%; overall diagnostic accuracy - 75.23%). In patients of working age the presence of coronary heart disease and elder age are risk factors of stroke. The presence of coronary heart disease and employment are risk factors of in-patient mortality. Whereas presence of hypertension and employment decreases risk of lethal outcome.

[The persistent disability of population in the Russian Federation: analysis and assessment of regional characteristics].

The disability is one of the main indices of public health, along with medical and demographic characteristics, morbidity and physical development that characterizes level of social economic development and is a major problem of health and social care authorities. The availability of statistical data and analysis of problem of population disability will allow to properly plan activities of various administrative bodies. The article presents trends of persistent disability in the Russian Federation during the studied period. In recent years, total number of disabled people has been gradually decreasing. In Russia, most of disabled people have disability group II. At the same time, the percentage of persons with group III increases and proportion of disabled persons with the groups I and II gradually decreases. The children disability in Russia tends to increase. In the Russian Federation, the analysis of regional differences in disability is presented. The analysis and assessment of regional characteristics of disability are necessary for planning and forecasting measures of medical and social support of persons with disability. The analysis of available statistical data permitted to established interdepartmental dissociation on this issue. The results of the study permitted to conclude that the need of increasing attention to the problem of disability results in strengthening interdepartmental interactions and developing of unified register of disabled people.

[The state and problems of pharmaceutical support of preferential categories of citizen].

The Federal program of supplementary preferential pharmaceutical support of particular categories of citizen functions since 2005. During this period, it seriously impacted on quality of pharmaceutical support, accessibility of medications, development of pharmaceutical market in general. The article presents analysis of state of pharmaceutical support of particular categories of citizen during 2017-2018. The established problems requiring solution are discussed too. It is established that in majority of cases the problems with pharmaceutical support have organizational specificity. The health care authorities allow decreasing of volumes including shortcomings in purchase and logistic of deliver, untimely holding of auctions, inconsistent compiling of applications and insufficient control of trade stock management. The problems with accessibility of pharmaceuticals occur because of inefficient application of already bought items. The open access data of official web-site of Minzdrav of Russia and Roszdravnadzor were used for analysis and preparation of article.

[About Problems of Palliative Care].

The palliative care is determined as "a complex of medical interventions targeted to deliverance from pain and relief of other severe manifestations of disease, for improving quality of life of terminally ill citizens" (Art. 36 of the Federal Law of 21.11.2011 № 323FZ) on the stage of uncontrolled progression of disease. The actual status and accessibility of palliative care was analyzed, including development of this issue in both the Russian Federation and number of foreign countries. According to the WHO, in Russia, 360-460 out of 100,000 population need palliative care. Out of them, 200 individuals with oncologic diseases, 150 individuals with non-malignant diseases and 12 individuals with AIDS/HIV. The health authorities face the task of significant increasing of scope of palliative care to make it more accessible. In recent years, issues of palliative care were intensively considered at the level of patients, of public organizations and legislators, as well as at the level of physicians, the Ministry of Health Care officials and others. Despite the great attention of researchers to issues of palliative care, the majority of physicians confirm its low accessibility to patients, as testify the results of survey of health workers carried out by the Foundation of Independent Monitoring of Medical Services "Zdorovie". The article also considers issues of normative base regulating palliative care provision and application of narcotic analgesics. The analysis of study results permits to conclude that despite considerable attention to palliative care, the issue of its accessibility continoue to be very actual.

[On the Issue of Development of the International Classification of Diseases].

The article presents history of development and becoming of the International Classification of Diseases (ICD), including its importance and necessity for health care.

[The Russian Italian Round Table in the N. A. Semashko National Research Institute of Public Health about the Problem of In-Hospital Infectious Diseases and Antibiotic Resistance].

The article presents the results of information exchange within the framework of the Russian Italian round about the problem of in-hospital infectious diseases and antibiotic resistance and the role of bacteriophages in inhibition and prevalence of antimicrobial resistance organized and carried out in The Federal State Budget Scientific Institution «N. A. Semashko National Research Institute of Public Health¼ (Moscow, Russia).

[The Problems of Statistical Registration of Mortality Because of External Causes in Russia].

The physical accessibility of pharmaceuticals considering space-time factors and assortment accessibility is minutely considered on the example of the Sakhalin oblast. The conclusions considering universality of factors of accessibility and availability in every subject are made emphasizing necessity of characteristics to be taking into account. The analysis of factors of accessibility in the subject permits to establish risk zones preventing accessibility of pharmaceutical for population.

[The Scientific Analysis of Factors of Physical Accessibility of Medications as Exemplified by the Sakhalin Oblast. Part II].

The Sakhalin oblast is considered as a detailed example of physical accessibility of pharmaceuticals with regards to time-space factors and assortment accessibility. The conclusions are made concerning universality of factors of accessibility and availability of characteristics to be taken into account in every subject. The analysis of factors of accessibility in the subject permits to establish risk zones preventing accessibility of pharmaceuticals to population.

[The characteristics of implementation of processing approach into management of regional system of organization of ophthalmologic care of population of the Tverskaia oblast with patterning conceptual model of management].

The study was carried out to establish characteristics of implementation of processing approach to management of regional system of organization of ophthalmologic care of population of the Tyumenskaia oblast and to develop conceptual model of management of profile service. The article considers characteristics of implementation methodological tools of processing approach to management of regional profile ophthalmologic service. The developed and scientifically substantiated conceptual model of management is considered.

[Health status of childbearing population of women in regions with different levels of infant mortality]. / Sostoianie zdorov'ia rozhaiushchego kontingenta zhenshchin v regionakh s razlichnym urovnem mladencheskoi smertnosti.

Under conditions of present demographic situation in the USSR with a view of scientific substantiation of priority directions in the development of regional programmes of medico-social activities in the field of maternal and child health the major importance is being given to the valid information on the health status of mothers and factors of social environment determining the conditions for intrauterine development of foetus and the formation of child health at early stages of life under conditions existing in specific regions. For this purpose simultaneously in Panevezhis, Lipetsk and Fergana which are representatively reflecting the specificity of regions with low, average and high infant mortality, on the basis of unified methodology a complex socio-hygienic survey of three cohorts of children of 1986 year of birth and their mothers during the present period of pregnancy and delivery was conducted. The data suggested the rise in the level of pathology identified during pregnancy and delivery among Fergana women as compared with Lipetsk and especially Panevezhis women.